If you’ve spent much time flying you’ve probably heard suggestions to avoid developing deep vein thrombosis, “Get up! Walk around. Do some squats.” But what is deep vein thrombosis? If you never fly do you have nothing to worry about? And how do we test and treat DVT?

What is Deep Vein Thrombosis?

DVT occurs when a blood clot develops in a deep vein in the body, usually in the legs.

Think of a blood clot as a traffic jam: the torrent of vehicles trying to get out of the area make it nearly impossible for other cars to come in. The blood clot usually forms on the valves of a deep vein and creates an obstruction to the outflow of blood. This creates swelling, redness and pain.

According to the Centers for Disease Control and prevention, as many as 900,000 Americans are diagnosed with DVT annually.

Risk factors for DVT

Although blood clots have an increased prevalence with age, many assume clots only happen to older adults. However, the challenges can appear across the age spectrum from teens to seniors.

At some point in our lives, we have all been at risk of developing a DVT or subsequent pulmonary embolism. A pulmonary embolism most commonly results from a blood clot that migrates through the heart into the arteries of the lung. It can be life-threatening if untreated.

The Cleveland Clinic Center for Continuing Education cites PE as the third most common cardiovascular illness after acute coronary syndrome and stroke.

It is important to recognize these risks in order to prevent this risk of DVT:

Frequent travel (long flights or car rides)

People who are immobilized

Major surgery or trauma

Past history of DVT

Pregnancy

Women taking oral birth-control

Obesity

Cancer

Autoimmune disorders such as lupus

What are the symptoms?

The symptoms of DVT can range from:

Minor pain and swelling to significantly swollen legs and arms

Changes in skin color (redness)

Leg pain

Leg swelling (edema)

Skin that feels warm to the touch

If the blood clot breaks off and moves through the bloodstream it can get stuck in the blood vessels of the lungs to form a pulmonary embolism.

Symptoms of a pulmonary embolism:

Chest pain

Coughing up blood

Light headedness

Sudden shortness of breath

How will your doctor test for DVT?

Your doctor will perform a physical exam and

A blood test called a D-dimer is a fast way to test for evidence of a blood clot.

Duplex ultrasound. TMC uses duplex ultrasound imaging to evaluate for DVT. Duplex ultrasound combines both traditional and Doppler ultrasound. The Doppler ultrasound creates a picture of the venous blood flow and can identify which vein the clot has developed in and how extensive it is.

What to expect when having a duplex ultrasound exam?

PE is best diagnosed with a CT scan of the chest. Certain high-risk patients may get another test called a V/Q scan.

How we treat DVT and PE

With a problem this prevalent, TMC has developed one of the busiest programs in the nation for minimally invasive DVT and PE interventions.

DVT is easier to treat the earlier it is caught. Patients are started on blood thinners right away. If the DVT is extensive and the symptoms are severe, they’re evaluated for intervention and clot removal.

DVT can typically be fixed during one or two treatments.

Dr. Lucas explained the treatment advancements are put to best use. “As vascular surgeons, we see the consequences of untreated DVT and PE and therefore are aggressive in our management of these conditions.”

Dr. Layla Lucas of Saguaro Surgicalis board-certified in General Surgery and Vascular/ Endovascular Surgery. Dr. Lucas has a special interest in wound healing, limb salvage, stroke prevention and treatment of aneurysmal disease. She has been trained in a wide variety of minimally invasive endovascular techniques, as well as traditional open procedures in order to treat the full spectrum of vascular diseases.

Meet Ashley Marcolin, registered vascular technologist at TMC and one of six RVTs that perform vascular screening exams at TMC. Ashley is the newest addition to the team, but manager Sarah Yeager reports Ashley reflects the kindness, compassion and empathy typical of the whole team.

“When people come in for a vascular exam they’re often very nervous. Whether they’re in the hospital for a vascular-related concern or a vascular wellness screening, I want them to know that they can relax, this is a very non-invasive test. We use no radiation, no dyes, no needles, and it takes just 30 minutes.” Ashley said. “This really is a very simple way to catch serious conditions early before they become life-threatening. The screening can save a life, and it takes very little time.”

While Ashley is a new member of the team, she has a lot of experience with performing exams of this kind. In her training, she had to complete 960 clinical hours using the techniques she now uses every day. We calculated how many exams she has performed since she started at TMC, where she also completed her clinical training. It runs into the thousands. “You know when you come to TMC that your technologist is a registered vascular technologist and has undergone a two-year intensive or four-year course before they can even take the certification exams,” Sarah explained.

What is involved in a vascular wellness screening?

We do three separate tests that together take about 30 minutes. You need to fast for four hours beforehand and wear loose-fitting clothing that allows easy access to the abdomen, neck, legs and arms. You do not need a doctor’s referral to schedule an appointment, but we will need the name of your primary care physician to send the results.

Ankle-Brachial Index

We use ultrasound scans along with blood pressure cuffs on the ankles and arms to screen for blockages or signs of disease in the arteries of the limbs. For this exam, you need to take your shoes and socks off. This is a screening for peripheral artery disease. PAD is a very common condition, especially in people over the age of 50. PAD can cause chronic leg pain when you’re walking or performing other exercises.

Abdominal Aortic Aneurysm Screening

This screening uses ultrasound scans looking for a ballooning of the wall of the abdominal aorta. If this ballooning or aneurysm ruptures it can be fatal. For this screening, you lie on your back while an RVT places the ultrasound transducer on several areas of your abdomen. The transducer has a bit of warm gel on the end. The gel helps us get clearer pictures and will not hurt your skin. You may feel slight pressure from the transducer as it moves along your body.

Carotid Artery Duplex Evaluation

Using an instrument called a transducer, the RVT scans the carotid artery in your neck to check the flow of blood, which informs us of plaque and blockages that put you at risk for an ischemic stroke.

Should you get a vascular screening?

Sarah and Ashley suggest that everyone over the age of 50 with any of the below listed risk factors get a vascular screening, and that any additional testing or screenings should be repeated at your physician’s direction.

You may also be at increased risk of arterial vascular disease if you have one of the following:

Have a family history of abdominal aortic aneurysm

Smoke or have a history of smoking

Have diabetes

Have high cholesterol and/or high blood pressure

Have coronary artery disease

When will I get the results?

Our exams are read in house by a vascular surgeon and the results sent to you within 3-5 days.

Three reasons to have a vascular screening:

It’s quick, easy and painless

It’s affordable

It can help prevent stroke and detect abdominal aortic aneurysm and peripheral artery disease

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About TMC

Tucson Medical Center, licensed at more than 600 beds, has been Tucson’s locally governed nonprofit regional hospital for more than 70 years.

TMC is Southern Arizona’s leading provider for emergency care and pediatric care (including Tucson’s first Pediatric Emergency Department), with top-notch intensive care units for adults, children and newborns.